Gambling Risk Research Articles

Loot box purchasing is associated with gambling and problem gambling when controlling for known psychological risk factors of gambling

Background A robust literature has found that loot box purchasing is associated with gambling and problem gambling. However, it remains unclear whether this association is merely an artifact of known psychological risk factors for gambling. The present study thus examined associations of loot box purchasing with gambling and problem gambling while controlling for potential psychological confounders. Methods Current gamers, recruited from five Canadian universities (N = 1189) and Academic Prolific and Reddit (N = 499), reported on loot box engagement, gambling engagement, and psychological characteristics. In each sample, binomial logistic regression analyses were used to examine the association between past-year loot box purchasing and likelihood of past-year gambling. Hierarchical linear regression analyses were used to examine the associations of each of past-year loot box purchasing and risky loot box engagement with problem gambling severity. Results In both samples, having purchased loot boxes in the past year was significantly associated with increased likelihood of having gambled in the past year and greater problem gambling severity. In the student sample, greater risky loot box engagement was significantly associated with increased problem gambling severity. Conclusions Consistent with previous research, there exist associations between loot box purchasing and gambling. Results suggest that these associations are robust to known psychological risk factors for gambling, reducing plausibility of the notion that the association between loot box purchasing and gambling exists only due to shared psychological vulnerabilities. Loot box purchasing represents an important marker of risk for gambling and problem gambling among people who play video games.

Unpacking the root causes of gambling in the Asian community: Contesting the myth of the Asian gambling culture.

Problem gambling is a public health issue both in the United States and internationally and can lead to mental health and socioeconomic concerns for individuals, families, and communities. Large epidemiological studies on problem gambling have neglected to include working-class, immigrant Asian Americans, who are at higher risk for problem gambling. The lack of data on Asian American gambling may explain a subsequent lack of culturally and linguistically appropriate treatment and prevention services. Additionally, the invisibility of Asian American data in published literature has helped to perpetuate a commonly held myth of an Asian gambling culture. This stereotype of the "Asian gambler" is a form of anti-Asian racism which serves to ignore and minimize the root causes of problem gambling in the Asian American community. Utilizing a community-based participatory research approach, 40 interviews were conducted with the local Khmer (n = 12), Chinese (n = 20), Korean (n = 3), and Vietnamese (n = 5) immigrant communities in the Greater Boston region to assess how problem gambling manifests in the local Asian community. Interviews were conducted in language by bilingual/bicultural community fieldworkers experienced in serving their respective communities. Flyers and social media were used to recruit participants. The interviews were coded into themes which provided a better understanding of the patterns of systemic issues contributing to problem gambling in the Asian American community. Interviewees provided insights into the underlying issues of poverty and social and cultural loss due to immigration as root causes for problem gambling in the Asian American community. The interviews indicate that many individuals in these Asian immigrant communities, who are striving to make a living off low-wage and stressful jobs, struggle to integrate into American society. They often lack culturally appropriate and accessible social and recreational activities, a void that casinos capitalize on through targeted behaviors. Research must address the social and structural barriers in the Asian American communities rather than relying on the "Asian gambler" stereotype and assuming interventions for a general American problem gambler will work for Asian immigrants. The research points to a need for gambling interventions and services that are centered on lived experiences.

Being a refugee in childhood and health in adulthood

Abstract Aim To examine whether individuals who migrated to Sweden as refugees in childhood are more likely to experience poor mental and general health and violence in adulthood, compared to individuals born in Sweden, or who were migrants but not refugees. Methods This study included 151,614 individuals who answered the Swedish National Public Health Survey in 2018 or 2020. We grouped the participants into refugees in childhood, migrants in childhood, or non-migrants. Information about outcomes - mental health, general health, and risk behaviors - was collected through questionnaires. We analyzed the associations using logistic regressions. Results Overall, having been a refugee in childhood was generally not associated with poor general health and mental ill-health, risk behaviors, or exposure to violence, compared to those who were migrants or born in Sweden. However, there were some exceptions. For example, young men, who were refugees in childhood, had a higher likelihood of suicide attempts than non-migrants. Interestingly, childhood refugees and childhood migrants were less likely to use drugs and to have risky alcohol use as adults, compared to non-migrants, but were more likely to be risk gamblers. Conclusions Being a refugee in childhood was not, in general, associated with negative health consequences in adulthood with some exceptions, such as gambling, that will be discussed in the presentation. Key messages • In this study, refugee experience in childhood is not, in general, associated with worse health outcomes in adulthood. • There are certain risk groups that need to be highlighted such as young males with refugee experience in childhood.

Health in refugees and migrants who self-identify as sexual or gender minority

Abstract Background In 2019, 80 million individuals were forcibly displaced. Yet, there is little knowledge on the health of refugees and migrants who self-identify as sexual- or gender minority (SGM). The aim was to examine health and health-related behaviors in refugee and migrant individuals who identify as SGM, and in comparison, to their heterosexual peers. Methods This study included 168,952 persons aged 16-84 who answered the Swedish National Public Health Survey in 2018 and 2020. Participants were grouped into White heterosexual, White SGM, migrant heterosexual, migrant SGM, refugee heterosexual, and refugee SGM. Outcomes included mental health (f.e. mental ill-health, suicidal ideation), general health, risky behaviors (f.e drug and alcohol use), and experiences of violence. Associations were analyzed using logistic and linear regression adjusting for sex, age, and educational level. Results Being an SGM, regardless of refugee or migrant minority status, was associated with worse general health and mental ill-health compared to heterosexual peers including suicidal ideation in refugee SGM (OR 2.42, 95 % CI 1.44-4.08). Both refugees and migrants had for example lower odds of drug and risk alcohol use compared to heterosexual peers but higher odds of risk gambling (OR 1.88, 1.49-2.37 for refugee SGM). Transgender refugees had high odds for risk gambling (OR 8.62, 1.94-38.40) and exposure to physical violence (OR 7.46, 2.97-18.70). Conclusions In this national population-based study, SGM have worse mental and general health regardless of being refugee or migrant minority. SGM refugees did not have worse health compared to migrant and White SGM and their heterosexual peers. While more research is needed, our study shows the need for public health personnel to be aware of potentially worse health and adverse experiences in SGM individuals, regardless of ethnic origin including refugees. Key messages • Our study provides evidence for poorer health outcomes in diverse SGM-groups. • Policies tackling health in refugees and SGM are still inadequate.

In search of lower risk gambling levels using behavioral data from a gambling monopolist.

Lower-risk recommendations for avoiding gambling harm have been developed as a primary prevention measure, using self-reported prevalence survey data. The aim of this study was to conduct similar analyses using gambling company player data. The sample (N = 35,753) were Norsk Tipping website customers. Gambling indicators were frequency, expenditure, duration, number of gambling formats and wager. Harm indicators (financial. social, emotional, harms in two or more areas) were derived from the GamTest self-assessment instrument. Receiver operating characteristics (ROC) curves were performed separately for each of the five gambling indicators for each of the four harm indicators. ROC areas under the curve were between 0.55 and 0.68. Suggested monthly lower-risk limits were less than 8.7 days, expenditure less than 54 €, duration less than 72-83 min, number of gambling formats less than 3 and wager less than 118-140€. Most risk curves showed a rather stable harm level up to a certain point, from which the increase in harm was fairly linear. The suggested lower-risk limits in the present study are higher than limits based on prevalence studies. There was a significant number of gamblers (5-10%) experiencing harm at gambling levels well below the suggested cut-offs and the risk increase at certain consumption levels. Risk of harm occurs at all levels of gambling involvement within the specific gambling commercial environment assessed in an increasingly available gambling market where most people gamble in multiple commercial environments, minimizing harm is important for all customers.

Health and health-related behaviours in refugees and migrants who self-identify as sexual or gender minority - A National population-based study in Sweden.

SummaryBackgroundTo examine health and health-related behaviors in migrant and refugee individuals who identify as sexual or gender minority, and in comparison to their heterosexual peers.MethodsThe study included 168,952 individuals (aged 16–84 years, males: 45·9%, sexual or gender minorities: 3·1%) who answered the Swedish National Public Health Survey in 2018 and 2020. Participants were grouped into Swedish-and Western-born (White) heterosexual, White sexual- or gender minority, migrant heterosexual, migrant sexual- or gender minority, refugee heterosexual, and refugee sexual- or gender minority. Outcomes included mental health (for example suicidal ideation, wellbeing), general health, risky behaviors (risk alcohol use, risk gambling, and substance use), and experiences of violence. Associations between 1) sexual- or gender -ethnic identities and 2) gender-ethnic identities and all outcomes were analyzed using logistic and linear regression adjusting for sex, age, and educational level.FindingsBeing a sexual- or gender minority, regardless of ethnic minority status, was associated with worse general health and mental ill-health compared to heterosexual peers including suicidal ideation in refugee sexual- or gender minority individuals (OR 2·42, 95 % CI 1·44–4·08). Ethnic minorities (heterosexual and sexual- or gender minority migrants and refugees) had lower odds of drug and risk alcohol use compared to White heterosexual peers but higher odds of risk gambling (1·88, 1·49–2·37 for refugee heterosexuals). Transgender refugees had high odds for risk gambling (8·62, 1·94–38·40) and exposure to physical violence (7·46, 2·97–18·70).InterpretationIn this national population-based study, sexual and gender minority individuals have worse mental and general health regardless of ethnic minority status. We did not find evidence for worse health in sexual- or gender minority refugees in comparison to migrant, and White sexual- or gender minorities and their heterosexual peers. Transgender individuals (White and ethnic minority) experienced significantly higher levels of physical violence. Public health policy should emphasize preventive measures to reduce exposure to violence and discrimination in sexual- and gender minority individuals, increase access and use of mental healthcare services and sensitise healthcare professionals about higher rates of health and related issues faced by sexual- and gender minority individuals including those with multiple minority identities.FundingWe received no external funding for this study and hence the funder had no role in the study design, data collection, data analysis, data interpretation, writing of the manuscript and the decision to submit.

The Prevention of Adolescent Problem Gambling Through Probabilistic Reasoning: Evidence of the Intervention’s Efficacy

Preventive efforts are necessary to reduce the risk for problem gambling among adolescents, especially among more at-risk youth. However, only a small proportion of the preventive initiatives implemented in the field of adolescent problem gambling are based on robust theoretical models and have been evaluated in their efficacy. By referring to the dual-process model of human functioning, especially to the mindware concept, the goal of this study was to develop and evaluate a school-based preventive intervention based on teaching probabilistic reasoning ability and explaining biases in reasoning with probability. Indeed, research with adolescents found that poor probabilistic reasoning ability is associated with gambling-related cognitive distortions that, in turn, are a risk factor for problem gambling. The study aim was to reduce gambling-related distortions by working on the concept of randomness and probability. A pre- and post-test design was performed with 72 adolescents randomly assigned to a Training group and a No Training group. Results showed a significant reduction of cognitive distortions at the post-test only in the Training group. Findings suggest that teaching probability can serve to reduce the susceptibility to gambling-related distortions and should be pointed out in the training process of the intervention providers in the gambling field.

Adolescents Who Play and Spend Money in Simulated Gambling Games Are at Heightened Risk of Gambling Problems.

Simulated gambling, such as playing a virtual slot machine for points rather than money, is increasingly part of the online gaming experience for youth. This study aimed to examine (1) if youth participation in simulated gambling games is associated with participation in monetary gambling; (2) if youth participation in simulated gambling games is associated with increased risk of problematic gambling when controlling for breadth of monetary gambling (i.e., number of gambling forms); and (3) if monetary expenditure and time spent playing simulated gambling games increase the risk of problematic gambling. Two samples of Australians aged 12–17 years were recruited—826 respondents through an online panel aggregator (mean age 14.1 years) and 843 respondents through advertising (mean age 14.6 years). Aim 1 was addressed using chi-square and correlation analyses. Linear multiple regression analyses were conducted to address Aims 2 and 3. The findings in both samples supported the study’s hypotheses—that (1) youth who play simulated gambling games are more likely to participate in monetary gambling, and that (2) participation and (3) time and money expenditure on simulated gambling are positively and independently associated with risk of problematic gambling when controlling for the number of monetary gambling forms, impulsivity, age and gender. To better protect young people, simulated gambling should, at minimum, emulate the consumer protection measures required for online gambling.

Young women's engagement with gambling: A critical qualitative inquiry of risk conceptualisations and motivations to gamble.

Younger women's engagement with gambling has changed over recent decades due to a range of socio-cultural, environmental and commercial factors. However, younger women's distinct lived experiences with gambling have rarely been considered. The following critical qualitative inquiry explored factors that influenced younger women's engagement with gambling and their perceptions of gambling risks. Semi-structured interviews were conducted with 41 Australian women aged 18-40 years. Participants were asked questions relating to their reasons for gambling, and the perceived risks associated with gambling. Reflexive thematic analysis was used to interpret the data. Five themes were constructed from the data. First, women reported that they gambled to escape their everyday lives, with some women reporting gambling within their own homes. Second, women reported gambling for financial reasons, particularly to change their life circumstances and outcomes. Third, gambling was used by women as a way to connect with social network members. Fourth, gambling was an incidental activity that was an extension of non-gambling leisure activities. Finally, lower risk perceptions of participants' own gambling risk contributed to their engagement and continuation of gambling. Public health and health promotion initiatives should recognise that young women's gambling practices are diverse, and address the full range of socio-cultural, environmental and commercial factors that may influence younger women's engagement with gambling.

Not Too Much, Not Too Often, and Not Too Many: the Results of the First Large-Scale, International Project to Develop Lower-Risk Gambling Guidelines

AbstractUntil now, there has been no evidence-based, specific advice for people who gamble who want to reduce their risk of experiencing gambling harms. This paper presents the results from the first large-scale, comprehensive, international project to develop lower-risk gambling guidelines. Specifically, we calculated relative risk estimates to determine risk of harm across the range of possible limits for gambling frequency, expenditure, and number of types of gambling engaged in; conducted an online survey (n = 4583) of people who gamble to assess whether they understood and found credible the proposed quantitative limits; conducted a series of interviews and focus groups with people who gamble to assess self-control strategies and reactions to proposed quantitative limits; conducted a meta-analysis of problem gambling risk factors in the general population; and consulted with a pan-Canadian, multi-sectoral committee of stakeholders. Project outcomes were examined and deliberated by a working group of scientists who decided upon a set of recommendations for lower-risk gambling. This paper presents these recommendations.

Prediction of problem gambling by demographics, gaming behavior and psychological correlates among gacha gamers: A cross-sectional online survey in Chinese young adults.

ObjectiveThe objective of this study is to explore the association of problem gambling with demographics, psychological distress, and gaming behavior in young adult gacha gamers in Hong Kong.Materials and methodsCross-sectional data was collected in the first and fifth waves of COVID-19 pandemic in Hong Kong online. Participants who aged 18–25 years and had been playing gacha games over the past 12 months were recruited. Stepwise multiple regression was used to explore the association among risk of problem gambling, gaming behavior, participation in gaming activities and psychological distress. A two-sided p-value <0.05 was considered as statistical significance.ResultsThree hundred and thirty-seven completed questionnaires were received with no missing data. 34.7% (n = 117) of the participants had non/low-risk of problem gambling. About 40% (n = 136) of them had moderate-risk and the remaining 25% (n = 84) were at high risk of problem gambling. A higher proportion of female participants (78.6%) were found in high-risk group as compared to 39.7% and 55.6% only in the non/low-risk and moderate-risk groups, respectively. The regression model (R2 = 0.513, F = 71.895, p < 0.001) showed that 51.3% of the variance of the total problem gambling score could be explained by stress, anxiety, monthly expenses on gacha purchases, number of motives for gacha purchase and number of gambling activities engaged.ConclusionThe present study provides empirical evidence to support the association between problem gambling and microtransaction especially for gacha which is the most popular type of video game microtransaction in Asia. The established regression model suggests that gacha gamers with higher risk of problem gambling tend to have greater stress, higher anxiety level, spend more on gacha purchase, have more motives for gacha purchases and engage in more gambling activities. In contrast to the extant literature, higher proportion of female participants in high-risk group indicates that female gacha gamers are also at very high risk of becoming problem gamblers.

Red Light or Green Light? Netflix Series’ Squid Game Influence on Young Adults’ Gambling-Related Beliefs, Attitudes and Behaviors, and the Role of Audience Involvement

ABSTRACT Media exposure for dark consumption products mostly shows glamorized and positive portrayals, rarely showing the negative consequences of consuming those products. However, the Netflix series Squid Game addresses the issue of gambling in its most extreme forms and shows the negative consequences related to it in a shocking manner, which begs the question whether watching the series could act as a preventive tool to increase risk perceptions, de-normalize gambling and reduce gambling behavior. A pre-registered survey study (N = 271) examined whether watching the Netflix series Squid Game affected young adults’ (18 to 35 years old) gambling intentions and play behavior through risk perceptions, subjective norms and attitudes toward gambling, and what role audience involvement plays. Although the results show that watching Squid Game increased young adults’ subjective norms of gambling (i.e. belief that significant others approve of the behavior in question) and further increased their positive attitudes toward gambling and gambling intention, the study also found an important impact of audience involvement. Audiences who were more involved with the series saw greater risks of gambling and perceived gambling to be less common. This resulted in more negative attitudes toward gambling and further less gambling intention and more motivation to change gambling behavior due to watching Squid Game.

Proximity to Casino Gambling Venues and Risk of Problem Gambling in Massachusetts

Proximity to Casino Gambling Venues and Risk of Problem Gambling in Massachusetts

Exposure to gambling promotions and gambling behaviours in Australian secondary school students

BackgroundYoung people’s gambling behaviours are associated with a range of individual, interpersonal and community factors. This study explored the association between exposure to types of gambling advertising and promotions and adolescent gambling behaviours. MethodsStudents from two states answered gambling questions as part of the 2017 Australian Secondary Students’ Alcohol and Drug (ASSAD) Survey. Students reported gambling behaviours (gambling in the last month, types of gambling activities), exposure to gambling promotions during the last 30 days (e.g. ads for gambling on TV, online, live studio crosses), and were assessed for problem gambling. Principal Component Analysis suggested four groups of gambling promotion exposure. Logistic regression analyses examined the association between gambling promotion exposure and student gambling, engagement in hard gambling activities in the last month, and problem or at risk gambling, controlling for a range of student characteristics. ResultsMost students (81%) had been exposed to some form of gambling promotion or advertisement in the last month, most commonly TV, social media and sporting event advertisements. Exposure to online gambling ads (including websites, pop-ups on websites, and social media) in the last month was significantly associated with gambling in the last month, and being classified as an at risk or problem gambler; but not with participating in hard gambling activities. After adjusting for exposure to gambling advertising across categories, no other advertising exposure types were associated with adolescent gambling behaviours. ConclusionsStudy findings point to the need to impose restrictions on gambling advertisements and promotions, particularly those presented online.

Making sense of gambling. Swedish youth navigating between risk and responsibility

ABSTRACT Youth gambling is commonly described in policy and research as a high-risk behavior. To design relevant measures to prevent gambling problems among youth, it is important to understand how youth themselves relate to gambling. To explore how youth navigate their position on gambling in the context of their everyday lives, we conducted qualitative interviews with 35 participants aged 17–21 years in Sweden; 15 had gambled and 20 had experience of others’ gambling. The thematic analysis showed that both gamblers and non-gamblers overall had negative attitudes toward gambling and emphasized repeatedly discourses of personal responsibility in it. The participants used various neutralization techniques to navigate the economic and addictive risks of gambling. Youth who gambled distanced themselves from the risks of gambling by drawing a line between themselves and excessive gamblers, between safe and unsafe gambling, or highlighted how their skills and strategic thinking made gambling less problematic. Also, gambling in liminal circumstances abroad or in alcohol-serving venues offered a safe time and place for gambling by separating it from everyday life practices. The findings provide important cues to how young people locate gambling in their everyday life, which is useful knowledge for policy and prevention.

Gambling: Exploring the Role of Gambling Motives, Attachment and Addictive Behaviours Among Adolescents and Young Women

There is a growing body of research that seeks to understand the aetiology, consequences and risk factors associated with addictive behaviours in youths. However, research examining the specific profile of adolescent females is very limited. Therefore, the objectives of the present study were, firstly, to explore the differences between attachment, gambling motives (social enhancement and coping), positive and negative affect, and addictive behaviours (gambling, drugs, spending, alcohol and video games) in female adolescents with and without risk of gambling problems. Secondly, the relationships between attachment, gambling motives, positive and negative affect and addictive behaviours were analysed in the subsample of female adolescents with problem gambling Thirdly, we examine the predictive role of positive and negative affect, gambling motives, and attachment in the aforementioned addictive behaviours. The sample was composed of 351 adolescents and young women, of which 312 had no risk of gambling and 39 had gambling problems. The results obtained revealed higher scores in drugs, spending, maternal attachment, and all gambling motives in the group of gambling problems. Likewise, analyses showed that the relevance of the predictor variables (attachment, gambling motives, and affect) varied according to the addiction that was taken as a reference point (i.e., gambling, drugs, spending, alcohol and video games).Consequently, the identification of the possible vulnerability factors for each addiction could be useful in the design of prevention and treatment approaches. In addition, the need for integrated and holistic health- and social- care programmes are suggested in terms of sex and age.

Gambling problems among United Kingdom armed forces veterans: Associations with gambling motivation and posttraumatic stress disorder

ABSTRACT Military service, mental health, and gambling activities and motivations as predictors of problem gambling in a sample of UK AF veterans. Age-and-gender matched veterans (n = 1,037) and non-veterans (n = 1,148) completed an online survey of problem gambling, gambling motivation, mental health (depression and anxiety), and posttraumatic stress disorder (PTSD). Past year problem gambling rates were higher in veterans compared to non-veterans. Veteran status predicted increased problem gambling risk. The relationship between problem gambling and gambling to cope with distress was significantly stronger among veterans. Veterans experiencing PTSD and complex PTSD (C-PTSD) were at increased risk of problem gambling. Overall, the present, findings contribute further international evidence that veterans are a population vulnerable to problem gambling. Veterans with PTSD or C-PTSD are most at-risk and may engage in problematic gambling to escape/avoid distress. Routine screening for gambling problems should be undertaken with current and former military personnel, and further research is needed on the interplay between gambling motivation and veterans’ mental health.

Gamblification: risks of digital gambling games to adolescents

Gamblification is the insertion of gambling mechanics into digital entertainment activities, including video games. Although the distinction between gambling, game playing, and consumer purchasing has traditionally been clear cut, diverse and new digital products increasingly blur these lines. Many products have strong gambling components that might not be perceived as such by adolescents—eg, virtual casinos and computer games with randomised rewards. Is such gamblification exposing a generation of adolescents to heightened risks of harm?

Can slogans prevent gambling harm?

Can slogans prevent gambling harm?

Microtransaction spending and problematic gambling of UK university call of duty gamers

ABSTRACT Increased implementation of loot boxes within computer games has received widespread concern for the wellbeing of gamers, especially given the increased engagement during COVID-19 restrictions. Loot boxes share similarities with traditional gambling mechanisms that influence addiction-like behaviors and the amount of money spent on in-game items. The present study investigated loot box expenditure alongside peer engagement, perceptions of gaming value, self-worth, and problematic gambling of 130 Call of Duty players. Results identified significantly higher Risky Loot Box Index and visual authority scores for high-risk and medium-risk problem gamblers than non-problem gamblers. High-risk problem gamblers were also found to have higher purchase intention and validation seeking scores than non-problem gamblers. Problem gambling risk and all but three self-worth and perceived value subscale behaviors were not associated with loot box expenditure, contrasting previous findings. Concerning peer influence, non-problem gamblers were significantly less likely to play any Call of Duty game with friends whilst having all or most friends purchase loot boxes were also found to be associated with higher RLBI scores. The findings continue to support the associations between loot box engagement and problematic gambling and suggests the need to continue to explore individual in-game motivations for engaging with microtransactions.